Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, ...Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation （rTMS） is non-invasive and may be an ideal treatment for co-occurring AUD ＋ mTBI ＋ PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD ＋ mTBI ＋ PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.展开更多
The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers ...The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally,we provide an overview of t DCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding t DCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding t DCS efficacy in psychiatry.展开更多
Random noise stimulation technique involves applying any form of energy(for instance,light,mechanical,electrical,sound)with unpredictable intensities through time to the brain or sensory receptors to enhance sensory,m...Random noise stimulation technique involves applying any form of energy(for instance,light,mechanical,electrical,sound)with unpredictable intensities through time to the brain or sensory receptors to enhance sensory,motor,or cognitive functions.Random noise stimulation initially employed mechanical noise in auditory and cutaneous stimuli,but electrical energies applied to the brain or the skin are becoming more frequent,with a series of clinical applications.Indeed,recent evidence shows that transcranial random noise stimulation can increase corticospinal excitability,improve cognitive/motor performance,and produce beneficial aftereffects at the behavioral and psychological levels.Here,we present a narrative review about the potential uses of random noise stimulation to treat neurological disorders,including attention deficit hyperactivity disorder,schizophrenia,amblyopia,myopia,tinnitus,multiple sclerosis,post-stroke,vestibular-postural disorders,and sensitivity loss.Many of the reviewed studies reveal that the optimal way to deliver random noise stimulation-based therapies is with the concomitant use of neurological and neuropsychological assessments to validate the beneficial aftereffects.In addition,we highlight the requirement of more randomized controlled trials and more physiological studies of random noise stimulation to discover another optimal way to perform the random noise stimulation interventions.展开更多
Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-defic...Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-deficit hyperactivity disorder(ADHD),but its efficacy(based on effect size calculations),safety,and stimulation parameters have not been systematically examined.In this systematic review,we aimed to(1)explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients,(2)evaluate the safety of tDCS application,especially in children with ADHD,(3)model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols,and(4)discuss and propose advanced tDCS parameters.Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach,a literature search identified 14 empirical experiments investigating tDCS effects in ADHD.Partial improving effects of tDCS on cognitive deficits(response inhibition,working memory,attention,and cognitive flexibility)or clinical symptoms(e.g.,impulsivity and inattention)are reported in10 studies.No serious adverse effects are reported in 747 sessions of tDCS.The left and right dorsolateral prefrontal cortex are the regions most often targeted,and anodal tDCS the protocol most often applied.An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes.In ADHD children,however,the electrical field induced by 1 mA,which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children,was sufficient to result in significant behavioral change.Overall,tDCS seems to be a promising method for improving ADHD deficits.However,the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes.Cortical regions involved in ADHD pathophysiology,stimulation parameters(e.g.intensity,duration,polarity,and electrode size),and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD.Developmental aspects of tDCS in childhood ADHD should be considered as well.展开更多
基金supported with resources by Department of Veterans Affairs(VA),Health Services Research and Development Service and the Office of Academic Affiliations(TPP 42-013)at Edward Hines VA Hospitalsupported by the following:VA OAA Polytrauma Fellowship to AAH,NIDRR Merit Switzer Research Fellowship Award H133F130011to AAH and the VA RR&D CDA-II RX000949-01A2 to AAH
文摘Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation （rTMS） is non-invasive and may be an ideal treatment for co-occurring AUD ＋ mTBI ＋ PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD ＋ mTBI ＋ PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.
文摘The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally,we provide an overview of t DCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding t DCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding t DCS efficacy in psychiatry.
基金supported by Cátedra Marcos Moshinsky (to EM)CONACyT Fronteras de la Ciencia#536 (to EM)+1 种基金VIEP-PIFI-FOMES-PROMEP-BUAP-Puebla (to EM)Comitéde Internacionalización de la Investigación (to EM),México
文摘Random noise stimulation technique involves applying any form of energy(for instance,light,mechanical,electrical,sound)with unpredictable intensities through time to the brain or sensory receptors to enhance sensory,motor,or cognitive functions.Random noise stimulation initially employed mechanical noise in auditory and cutaneous stimuli,but electrical energies applied to the brain or the skin are becoming more frequent,with a series of clinical applications.Indeed,recent evidence shows that transcranial random noise stimulation can increase corticospinal excitability,improve cognitive/motor performance,and produce beneficial aftereffects at the behavioral and psychological levels.Here,we present a narrative review about the potential uses of random noise stimulation to treat neurological disorders,including attention deficit hyperactivity disorder,schizophrenia,amblyopia,myopia,tinnitus,multiple sclerosis,post-stroke,vestibular-postural disorders,and sensitivity loss.Many of the reviewed studies reveal that the optimal way to deliver random noise stimulation-based therapies is with the concomitant use of neurological and neuropsychological assessments to validate the beneficial aftereffects.In addition,we highlight the requirement of more randomized controlled trials and more physiological studies of random noise stimulation to discover another optimal way to perform the random noise stimulation interventions.
基金This review was supported by the Department of Psychology and Neurosciences,Leibniz-Institut fiir Arbeitsforschung Ministry of Science,Research and Technology,Deputy of Scholarship and Students Affairs,Iran(95000171)the German Ministry of Research and Education(German Center for Brain Stimulation grant number 01EE1403C).
文摘Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-deficit hyperactivity disorder(ADHD),but its efficacy(based on effect size calculations),safety,and stimulation parameters have not been systematically examined.In this systematic review,we aimed to(1)explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients,(2)evaluate the safety of tDCS application,especially in children with ADHD,(3)model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols,and(4)discuss and propose advanced tDCS parameters.Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach,a literature search identified 14 empirical experiments investigating tDCS effects in ADHD.Partial improving effects of tDCS on cognitive deficits(response inhibition,working memory,attention,and cognitive flexibility)or clinical symptoms(e.g.,impulsivity and inattention)are reported in10 studies.No serious adverse effects are reported in 747 sessions of tDCS.The left and right dorsolateral prefrontal cortex are the regions most often targeted,and anodal tDCS the protocol most often applied.An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes.In ADHD children,however,the electrical field induced by 1 mA,which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children,was sufficient to result in significant behavioral change.Overall,tDCS seems to be a promising method for improving ADHD deficits.However,the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes.Cortical regions involved in ADHD pathophysiology,stimulation parameters(e.g.intensity,duration,polarity,and electrode size),and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD.Developmental aspects of tDCS in childhood ADHD should be considered as well.
